Abstract: In this case, researchers report a 26 years old multigravida with 35 weeks of gestation presenting with torsion of paraovarian cyst. She presented to the antenatal clinic with acute abdominal pain. Ultrasound revealed 15×10 cm adnexal cyst. She was diagnosed to have torsion of adenxal cyst during pregnancy. Laparotomy was done with total excision of the cyst which was paraovarian and delivery of the baby by caesarian section because of preterm labour with history of caesarian sections twice before. She delivered a healthy female baby. The operative time was 90 min. The patient was released from the hospital 3 days after surgery in good general condition. Her histopathology report showed a gangrenous paraovarian cyst. Paraovarian torsion is relatively uncommon pregnancy. Diagnosis can usually be made on the basis of the characteristic clinical presentation in conjunction with ultrasound evidence of a unilaterally enlarged adnexal mass and surgery. Treatment options are limited to surgery either by laparoscopy or laparotomy but the former becomes more difficult after second trimester.